Peritoneal Dialysis-related Infections and Key performance indicators in Patients on Long-Term Peritoneal Dialysis
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Abstract
Background: Peritoneal dialysis (PD) is a renal replacement therapy for patients with end-stage renal disease (ESRD). Peritoneal Dialysis-Related Infections are the major cause of morbidity and mortality. The study was conducted to identify the incidence and epidemiological data of peritoneal dialysis-related infection as well as key performance indicators in peritoneal dialysis patients. Methods: The prospective study was conducted using patient record form and PD registry database from the Dialysis Unit in Phra Nakhon Si Ayutthaya Hospital. The study was focused on the incidence of peritoneal dialysis-related infections, causing pathogens, risk factors, patient outcome, and key performance indicators. Results: Three-hundred four patients included in the study. Peritoneal fluid cultures were found negative in 26.1% in PD-related peritonitis. The incidences of exit-site infection, and PD-related peritonitis were 0.07, and 0.35 episodes per patient-years, respectively. PDrelated peritonitis was frequently caused by catheter-related (31.5%). The most common infecting organisms of PD-related peritonitis were gram positive cocci (38%). A total of 66.3% of the infections responded to initial antibiotic therapy administered in the dialysis fluid. Peritonitis-related death was 7.6%. Significant predictors for PD- related peritonitis were decreasing value of blood urea nitrogen, serum albumin, sodium, and calcium. The significant factors of treatment failure were causative organisms with fungi. Conclusion: Key performance indicators in peritoneal dialysis patients in Pra Nakhon Si Ayutthaya Hospital achieved The Nephrology Society of Thailand recommendation. Gram positive organism is still a very common organism that generally responds well to antibiotic therapy. The causative organisms with fungi were the independent significant risk factors for treatment failure.
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